The following table summarizes restructuring, acquisition and related costs recorded in the accompanying consolidated statements of operations for the periods indicated (in thousands):


	Year Ended December 31,
	2024		2023		2022
2024 restructuring	$	10,486	$	—	$	—
2022 restructuring		—		8,961		1,414
2020 restructuring		—		2,853		2,994
Total restructuring related charges	$	10,486	$	11,814	$	4,408
Acquisition and related charges	$	3,223	$	1,000	$	(24	)
Total restructuring, acquisition and related costs	$	13,709	$	12,814	$	4,384

As a result of the Company’s acquisitions and ongoing integration activities, the Company initiated the 2024 restructuring program in the first quarter of 2024 in order to reduce operating complexity. During the year ended December 31, 2024, the Company recorded $10.5 million in severance, facility related and other charges in connection with the 2024 restructuring program. As of December 31, 2024, the Company had incurred cumulative costs of $10.5 million related to this restructuring program. The Company anticipates substantially completing the 2024 restructuring program in the first half of 2025 and expects to incur additional restructuring charges of $4.0 million to $5.0 million related to the 2024 restructuring program.

The following table summarizes restructuring costs associated with the 2024 restructuring program by reportable segment (in thousands):


	Year Ended December 31,		Cumulative Costs as of
	2024		December 31, 2024
Automation Enabling Technologies	$	3,198	$	3,198
Medical Solutions		6,769		6,769
Unallocated costs		519		519
Total	$	10,486	$	10,486

As a result of the Company’s ongoing evaluations and efforts to reduce its operating costs, while improving efficiency and effectiveness, the Company initiated the 2022 restructuring program in the third quarter of 2022. This program was focused on reducing operating complexity in the Company, including reducing infrastructure costs and streamlining the Company’s operating model to better serve its customers. In addition, the program was focused on cost reduction actions to improve gross margins for the overall company. As of December 31, 2024, the Company had incurred cumulative costs of $10.4 million related to the 2022 restructuring program. The 2022 restructuring program was completed in the fourth quarter of 2023.

The following table summarizes restructuring costs associated with the 2022 restructuring program by reportable segment (in thousands):


	Year Ended December 31,				Cumulative Costs as of
	2023		2022		December 31, 2024
Automation Enabling Technologies	$	6,771	$	1,358	$	8,129
Medical Solutions		1,359		56		1,415
Unallocated costs		831		—		831
Total	$	8,961	$	1,414	$	10,375

As a result of the Company’s ongoing evaluations and efforts to reduce its operating costs, while improving efficiency and effectiveness, the Company initiated the 2020 restructuring program in the third quarter of 2020. This program was focused on reducing operating complexity in the Company, including reducing infrastructure costs and streamlining the Company’s operating model to better serve its customers. In addition, the program was focused on cost reduction actions to improve gross margins for the overall company. As of December 31, 2024, the Company had incurred cumulative costs of $16.7 million related to the 2020 restructuring program. The 2020 restructuring program was completed in the fourth quarter of 2023. In January 2025, the Company sold an owned facility with a $3.6 million gain.

The following table summarizes restructuring costs associated with the 2020 restructuring program by reportable segment (in thousands):


	Year Ended December 31,				Cumulative Costs as of
	2023		2022		December 31, 2024
Automation Enabling Technologies	$	2,853	$	2,775	$	13,827
Medical Solutions		—		217		2,716
Unallocated costs		—		2		173
Total	$	2,853	$	2,994	$	16,716

The following table summarizes the accrual activities, by component, related to the Company’s restructuring programs recorded in the accompanying consolidated balance sheets (in thousands):


	Total			Employee Related			Facility Related			Other
Balance at December 31, 2022	$	2,410		$	1,902		$	452		$	56
Restructuring charges		11,814			5,832			4,452			1,530
Cash payments		(8,867	)		(6,675	)		(1,379	)		(813	)
Non-cash write-offs and other adjustments (1)		(2,507	)		(21	)		(1,845	)		(641	)
Balance at December 31, 2023		2,850			1,038			1,680			132
Restructuring charges		10,486			8,165			2,034			287
Cash payments		(5,898	)		(3,469	)		(2,007	)		(422	)
Non-cash write-offs and other adjustments		(687	)		(44	)		(646	)		3
Balance at December 31, 2024	$	6,751		$	5,690		$	1,061		$	—

(1) Non-cash write-offs and other adjustments included impairment of assets amounting to $2.5 million.

Acquisition costs incurred in connection with business combinations, primarily including finders’ fees, legal, valuation and other professional or consulting fees, totaled $3.5 million, $1.0 million, and $1.4 million during 2024, 2023, and 2022, respectively. Acquisition related costs/(income) recognized under earn-out agreements in connection with acquisitions totaled $(0.3) million, zero, and $(1.4) million during 2024, 2023, and 2022, respectively. A majority of the acquisition and related costs of $3.2 million for 2024 were not allocated to any of the reportable segments.